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Oct 27

Corrective Pigment Camouflage: Part 1 of 3

Part I of a 3-part series.

This article will deal with the consultation of a burn patient.

Information will include: patient expectations, the ability to tolerate pain (pre-procedure sedation), consulting with the patient’s physician, pre-care and photos.

Our primary concern is to correct tissue color defects and create the illusion of smoother looking skin. Dr. Francis Cook MacGregor, a research scientist and member of the rehabilitation team at New York University Medical Center, states “In our culture the way one looks makes a difference in the response one gets. It is this fact that defines one’s identity because it defines the reaction of others.” The mouth is the second most noticed feature of the face, preceded only by the eyes. The disfigured face may be transformed by plastic /reconstructive surgery, corrective cosmetics or by Corrective Pigment Camouflage (CPC).

Patient assessment includes two phases: 1) collection and 2) analysis of information. This is achieved through the interview and examination. Most burn patients have lower self-esteem, social anxiety and fear of rejection. With this in mind, it is imperative to obtain information vital to your overall plan. The patient’s past and present medical records contain data helpful to your overall assessment. These records should include a complete medical history including allergies to food, anesthesia, drugs, chemicals, metals, etc., and any diseases or disorders (psychological or physical).

Take time to establish a rapport with the patient, identify their needs and agree on goals. Thoroughly discuss their perception of their present situation and what the CPC can do. They must be made aware this procedure is a multi-step process and final results cannot be determined until all applications are completed.

When a person initially phones you for a consultation, be sure to ask who their physician is and if they are presently under their care. If they take medication or plan surgery in the next few months, work in concert with their physician. This will serve a dual purpose: the patient will achieve better results due to your access to their complete medical history and the physician will be able to see your work firsthand, which may lead them to refer other patients to you.

The evaluation should include the use of glycolic or other acid prior to procedure day. This exfoliation/desquamation is the process of removing dead cells from the epidermis. This application will remove only dead tissue, not living tissue. Ask their treating physician if they should see a dermatologist to set up an exfoliation program. We know the cell renewal rate is generally every 21-28 days. For younger people it is 3-4 weeks, for middle age adults it is 4-7 weeks and a mature adult’s skin regenerates itself at a rate of 7-12 weeks or longer. This information is also vital when rescheduling your patient for their next appointment. The exfoliation process makes the skin more receptive to pigment retention.

Have the patient drink 8-10 glasses of water daily, as this hydrates the skin. Other considerations include: limiting intake of caffeine, sodium, aspirin and alcohol 3-5 days prior to each procedure.

Thoroughly discuss what is feasible for you to achieve with CPC. Show photos of other burn and scar work from onset to finish. Even though every case is different, this will enable them to see what can be achieved.

Write a detailed description of your treatment plan and go over it with the patient. Both of you must be in total agreement with all phases of CPC. Getting them involved in their treatment should help them have control over their life, get them excited about living again, and give them confidence.

Use a good quality camera for clear, distinct photographs. I use both a Pentax IQ Zoom 900 and a 700 with a macro lens, and a Polaroid camera. The cost of these cameras is around $300-$400. We prefer Kodak or Fuji film with a speed of 200-400 or more. Take pictures from 12 inches, 2 and 3 feet away, as well as a full body shot. These photos will be crucial in developing your overall plan of assessment for CPC. Photograph the patient’s areas of concern and mark the areas. Place patch color tests in marked areas. This will be your guide for future pigment application. Always have visible proof of your work as documentation for any and all interested parties. This may include physicians, worker’s compensation cases, insurance companies, attorneys, technicians and others.

Most burn patients have been through numerous surgeries and they are either oblivious to pain during procedures or the pain is very intense. We use a topical anesthesia to reduce the pain. We have found the best anesthesia to be ULTRAcaine White by IIPC, first applied and then wrapped in an occlusive dressing. Anesthesia is applied 1/2-1 1/2 hours prior to procedure application. We also use 1-2 drops of Numit liquid anesthesia in our pigments.

Remember:

  • Never ask a patient the details of how they were burned.
  • An examination of facial morphology and symmetry is crucial.
  • Touching your patient will communicate safety and security.
Written by Susan Church CCPC
Director of Education
International Institute of Permanent Cosmetics
This article first appeared in the SPCP Jan./Feb. 1996 Newsletter
Note: We use the word “client” to refer to people we perform permanent cosmetic application on; We use the word “patient” to refer to people that have been referred to us by physicians. Corrective Pigment Camouflage is a most advanced procedure and should only be undertaken by experienced and trained permanent colour technicians.

For product information on ULTRAcaine White and NUMIT LIQUID phone

800.282.0577

or visit       www.PermanentMakeupProducts.com

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